ESIS Claims Team Leader WC

Are you ready to make a meaningful impact in the world of workers compensation Join ESIS a leader in risk management and insurance services where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS were dedicated to providing exceptional service and innovative solutions and were looking for passionate individuals to be part of our dynamic team. If youre eager to advance your career in a collaborative environment that values integrity and growth explore our exciting workers compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

ESIS is looking to hire a Workers Compensation Team Leader to supervise and direct the activities of Claims Representatives Specialists Claims Assistants and/or other clerical support positions in the investigation and management of workers compensation claims to ensure prompt efficient and fair claims handling. Ensure a high level of customer service and claim file quality.

GENERAL RESPONSIBILITIES:

• Improve the technical quality of files within the team.
• Act as a team facilitator to help remove barriers and take an active role in resolving team issues.
• Be an integral member of the Claims Office Workers Compensation Management Team.
• Be responsible for ongoing team development ensuring effective loss dollar management and providing valueadded customer service.
• Maintain a strong commitment to team building and ESIS management principles.
• Understand and utilize current information systems.
• Collect and analyze data to identify individual opportunities for improvement.
• Work with individuals to assess their knowledge and skill gaps and develop plans for enhancement.
• Promote ESIS Claims Management Division strategies and values.
• Address Human Resource issues and problems effectively.
• Demonstrate a proactive approach to servicing external and internal customers.
• Show understanding and ability to apply the technical aspects of claims handling.
• Provide oneonone coaching and counseling to team members.
• Effectively evaluate programs and procedures for continuous improvement.

SPECIFIC RESPONSIBILITIES:

• Review and assign all new claims based on customer needs and claim complexity.
• Determine initial reserves and provide direction to representatives as needed identifying issues with compensability medical conditions subrogation etc.
• Ensure that all coding and documentation are appropriate.
• Follow files according to diaries established by the system as well as individual claim file diaries based on the complexity of the file or customer agreements.
• Review files at key checkpoints for investigation medical management subrogation statutory requirements (forms etc. reserve accuracy fraud indicators and provide guidance on ESIS best practices as well as account and carrier requirements.
• Participate in account discussions regarding file issues if they escalate beyond the representative.
• Review status reports for accounts as needed and participate in file reviews as required.
• Manage overall performance for team members including attendance file quality service and interpersonal issues.
• Ensure reserve adequacy in compliance with ESIS and carrier requirements.
• Participate in litigation strategy sessions.
• Review and correct a variety of internal documents (reserves appeals internal audit requirements SAS 70 etc. sometimes completing them personally.
• Participate in the strategy and management of catastrophic injuries collaborating with accounts nurses representatives claims vice presidents the home office carriers etc.
• Conduct quality audits in addition to individual claim file reviews.
• Provide feedback and responses to carrier customer and broker reviews.
• Coordinate training for the team and often for the office on jurisdictional medical procedural carrier requirement and account requirement topics.
• Resolve concerns from customers claimants brokers or carriers if they escalate beyond the representative.
• Balance caseloads of representatives within the team and across the office.
• Train new hires in all aspects of claims handling.
• Manage the closing of cases to ensure they move quickly and accurately.

• A fouryear college degree and/or equivalent work experience or additional degrees (e.g. MBA).
• A high level of technical claims knowledge and competence in Workers Compensation claims demonstrated by at least 5 years of claims handling experience at ESIS or within a similar organization.
• Thorough knowledge of Workers Compensation products services and coverages along with a solid understanding of applicable legal principles.
• Knowledge of Workers Compensation cost containment programs and proven account management skills are essential.
• Relevant insurance designations such as Associate in Claims (AIC) Associate in Risk Management (ARM) AICPCU etc.
• Ability to plan organize and implement general business and people management practices evidenced by successful completion of Management and Technical Programs business or legal collegelevel curriculum or equivalent practical work experience.
• Demonstrated effective communication and interpersonal skills to interact with subordinates and all levels of ESIS personnel as well as attorneys producers and accounts.
• A solid understanding of teambuilding theory and its application to ongoing and planned activities.
• Ability to evaluate the effectiveness of various programs and procedures and incorporate improvements. Ability to facilitate and lead groups of people.
• Demonstrated evaluative thinking by seeking out and considering multiple sources of data to form conclusions and determine courses of action.
• Evidence of strengthening personal effectiveness by demonstrating confidence credibility and commitment to established strategies and values.
• Demonstrated creativity and selfmotivation in current position and activities through direct claims handling and other related functions.
• Evidence of the ability to manage activities and resource allocation issues ensuring timely highquality service and longerterm payback opportunities related to claims handling processes.

An applicable resident or designated home state adjusters license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESISs employment requirements for handling claims. ESIS supports independent selfstudy time and will allow up to 4 months to pass the adjuster licensing exam.

The pay range for the role is $66900 to $113700. The specific offer will depend on an applicants skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package more details on which can be foundon our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.

ESIS a multiline ThirdParty Administrator (TPA) provides claims risk control & loss information systems toFortune 1000 clients across its North American a full range of sophisticated risk management services including workers compensation claims handling; a broad spectrum of casualty insurance products such as general liability automobile liability products liability professional liability and medical malpractice claims handling; and disability management.